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A Thought Experiment (Updated)

Suppose there is a law requiring every father to purchase a car for each of his daughters or pay a hefty fine, and Smith and Jones set out to meet this obligation. Smith wants to buy his daughter a car with a turbocharged engine, and when he goes to the auto dealer he is told that such a car will cost $20,000, which he gladly pays. Jones, on the other hand, thinks turbocharged engines are dangerous, and would rather not buy his daughter a car with one. But the dealer informs him that another law requires that all new cars sold in the region come with turbocharged engines; there is no way to purchase a car without one. The salesman offers Jones a deal, though: he'll remove the $1,000 cost of the turbocharging from what Jones has to pay for the car, and remove any mention of it from the information included with the car when it's purchased. However, the manufacturer will send Jones's daughter a letter informing her that her car is turbocharged, and letting her know what this means and how it works.

And now answer the following question:

Is Jones required by law to purchase his daughter a turbocharged car?

Speaking for myself, it seems clear that the answer is "Yes": the fact (if it is a fact) that Jones wouldn't be paying for the turbocharging doesn't mean that he wouldn't be buying his daughter a car that has it, and so the only differences between Jones and Smith lie in what they want and what they pay, while what they have to buy (and so pay for) is in the relevant respect exactly the same. That the opportunity to buy a non-turbocharged car has been taken away from Jones is simply unaffected by the fact that the turbocharging is being given to him for free.In light of this, and bearing in mind the necessarily imperfect character of analogies and the well-documented difficulty of eliciting non-biased responses to cases like the above, consider the following policy:

... women will have free preventive care that includes contraceptive services no matter where she works [sic]. The policy also ensures that if a woman works for areligious employer with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide, payfor or refer forcontraception coverage, but her insurance company will be required to directlyoffer her contraceptive care free of charge.

More specifically:

The new regulation will require insurance companies to cover contraception if the religious organization chooses not to. Under the policy:oReligious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.oReligious organizations will not be required to subsidize the cost of contraception.oContraception coverage will be offered to women by their employers insurance companies directly, with no role for religious employers who oppose contraception.oInsurance companies will be required to provide contraception coverage to these women free of charge.o The new policy does not affect existing state requirements concerning contraception coverage.

Aside from the non-religious character of Jones's objection to turbocharging, in what relevant respects does the policy just described fail to be analogous to the one we imagined? (Again speaking for myself, the answer is "None".) And if they are analogous, then how is it that in being required to pay for a health insurance policy in which coverage for contraceptives has been included for free, a religious employer "will not have to provide contraception coverage", that they have "no role" in making such coverage available to their employees?UPDATE: The bishops seem to share my concern, writing in their analysis of the proposed policy that "in the case where the employee and insurer agree to add the objectionable coverage, that coverage is still provided as a part of the objecting employer's plan, financed in the same way as the rest of the coverage offered by the objecting employer. This, too, raises serious moral concerns."

Comments

By definition, analogies are never perfect (but boy do philosophers love them). Here's where this one fails: not every women has to receive contraception coverage. Or, to use your analogy, if Jones's daughter is obedient (and the paternalistic gloss is rather amusing), she would refuse the turbocharging. But you've already rigged it to that every car must include turbocharging. In fact, women who want to be good Catholics on this issue, the few, the proud, are not made to accept contraception coverage because it will be set up as a separate policy.We don't need analogies to help us understand the moral issues here. The level of cooperation with evil (and the moral theology here matters; it can't be ignored, not if one wants to make a Catholic moral argument) to which the bishops are now objecting is no different than the level at which they are already involved right now by virtue of paying insurance companies at all.

In fact, women who want to be good Catholics on this issue, the few, the proud, are not made to accept contraception coverage because it will be set up as a separate policy.In what sense is it "set up as a separate policy", Grant? I've seen that language bandied about, but it's nowhere in that document from the WH Press Office.And anyway, suppose the turbocharging can be turned on and off with a switch. How would this be relevantly different?

In the sense that senior administration officials explained it to me. The press release won't have all the details of the plan, because press releases with a lot of detail don't get read.Why do you need this analogy to understand what this means? There is no switch. There is a policy paid for by the employer that does not include contraception coverage. The insurance company on its own contacts the employee to make an offer of a free policy that would include contraception. The employee -- a moral agent separate from the employer -- must decide whether to avail herself of that policy.The employer does not have to pay for that coverage. The employer does to have to refer for that coverage. Catholic moral problem solved.

The employer does not have to pay for that coverage. To say this depends on the crucial (and completely unsubstantiated) assumption that contraceptive coverage really is free, rather than something that will be incorporated into the employer's premiums. If the cost of contraception is incorporated into premiums the same as before, and the only difference is that people are lying about it by saying that it's "free," how does that make the moral problem go away?

Every one of our acts involves moral problems. I am involved in one right now, as I type on a device made by people who are badly mistreated by their employers. Bishops are involved in another right now, as they cut checks to insurance companies who could use those funds to offset the cost of providing abortion coverage to other clients. These involvements are the reason the Catholic tradition developed categories of cooperation. They help us determine when a moral agent may involve himself with evil. They helped the bishop of Madison determine that it was not illicit for him to provide his employees with contraception coverage in compliance with state law because a.) it was too expensive to self-fund a health plan and b.) it was better to provide coverage that could lead to the use of contraception than not to provide health coverage at all.

In the sense that senior administration officials explained it to me. Have you considered the possibility that the administration officials are being imprecise or less than fully forthright, Grant? I ask that in the friendliest way possible.Every one of our acts involves moral problems. I am involved in one right now, as I type on a device made by people who are badly mistreated by their employers. Bishops are involved in another right now, as they cut checks to insurance companies who could use those funds to offset the cost of providing abortion coverage to other clients. These involvements are the reason the Catholic tradition developed categories of cooperation. They help us determine when a moral agent may involve himself with evil. They helped the bishop of Madison determine that it was not illicit for him to provide his employees with contraception coverage in compliance with state law because a.) it was too expensive to self-fund a health plan and b.) it was better to provide coverage that could lead to the use of contraception than not to provide health coverage at all.But as you showed in your earlier posts, where you argued that even though on the "old" interpretation of it the policy violated religious freedom still it was better for organizations to comply with it than to decline to provide health care (a position I was sympathetic to), this isn't the issue. It's possible to object on ethical grounds to an action that doesn't amount to direct involvement with evil, perhaps instead because you think it has the effect of making sin more likely.And why the analogy? Because it helps me at least to bring the issues into relief. Of course it ultimately boils down to the real-life particulars, but so far I'm not convinced that these are otherwise than I took them to be.

I have no comment on this analogy, but I do have a couple of relevant questions.1. Is it not the position of the USCCB that no one has a moral right to use or provide contraceptives for contraceptive purposes?2. Is it not the legal right of the state to determine which legal conditions of employment must obtain for all its citizens? More specifically, is it not the legal and moral right for the state to insist that, even if some legal condition happens to be objectively immoral, nonetheless good reasons can exist for not making the civil law outlaw every immoral practice? I ask these questions from the standpoint of Catholic moral thought. Obviously, in cases such as this present one, the government's position is that contraceptive practices are not objectively immoral. But even from the Catholic standpoint, I do not see that Catholic moral thought requires that Catholics oppose all civil legislation that allows for some objectively immoral practices to have legal sanction.Catholics in the U. S. have to live and work in a secular society. Their religious convictions may lead them to regret some features of that society's practices and to argue in the political arena for changes in civil law. But it does not follow that, unless they object to every practice that they find morally offensive that they are morally complicit in these practices that they find objectionable. Unquestionably, there are some practices that, even if they are legal, a Catholic could not in good conscience refrain from opposing. Legally mandated euthanasia or sterilization are two such examples. So too would be legally mandated abortions. But Contraception? If the bishops think so, then they need to make this case. Thus far, as best I can tell, they have not articulated a morally sophisticated position on this matter.

The employee a moral agent separate from the employer must decide whether to avail herself of that policy.--Grant Gallicho It may also be "himself" if it is a family policy and his wife and daughters use contraceptives. Your explanation of the insurance company contacting employees and inviting them to sign up for a separate policy is what I had assumed would happen.

Bernard: The relevant issue here isn't that of whether "objectively immoral practices" should be allowed. Rather, it's whether religious (and other) employers should be required by law to provide services that pay for them.

John: It is possible that the administration is lying to me (just call it lying, why don't you?). Given that the new policy has won the approval of the Catholic Health Association, which has been acutely sensitive to the question of cooperation, and Catholic Charities USA, which also raised objections along those lines, I tend to doubt it. The bishops' prolife office has lost my trust when it comes to evaluating U.S. health-care policy. They promised FOCA. They promised federal funding of elective abortion. I don't have any reason to believe they have this right, not when people who were actually close to the policymaking have told me otherwise.

It is possible that the administration is lying to me (just call it lying, why dont you?). Given that the new policy has won the approval of the Catholic Health Association, which has been acutely sensitive to the question of cooperation, and Catholic Charities USA, which also raised objections along those lines, I tend to doubt it. The bishops prolife office has lost my trust when it comes to evaluating U.S. health-care policy. They promised FOCA. They promised federal funding of elective abortion. I dont have any reason to believe they have this right, not when people who were actually close to the policymaking have told me otherwise.Yes, it is also possible that they are lying (which is not the same as being imprecise or less than forthright, as the Catholic moral tradition has always held). I'll just observe that reasoning like this is part of what led people like me, so many years ago, to trust the Bush administration's case for the Iraq War: clearly a much more serious issue, but still.

If it turns out not to be the case that there are separate policies, I will happily criticize the Obama administration for that -- while still maintaining that the bishops, according to Catholic moral theology, are perfectly justified in participating in such an arrangement because the proportionate good of providing health coverage to employees outweighs the remote cooperation with what they consider evil. I also wonder whether there are basic administrative requirements that would make offering free contraception coverage outside of a separate policy impossible.

I certainly appreciate and am grateful for this post, the comments above, and all the time, energy and talent people have devoted on this blog towards this issue and its implications.Having said that, I confess (both in the sense of telling the truth, and in the sense of admitting one's failings) that analogies like this one have me wondering how different we are from medieval theologians (whether apocryphal or not) debating how many angels can fit on the head of a pin.It's one thing for academic theologians to engage such questions. Given the pastoral challenges facing the US Church these days, I find it...discouraging I guess is a good word...that our bishops seem so engaged in an issue like this.

John,For what it's worth, I like your analogy (and have no problem with analogies in general). In fact, I like it better than the one I came up with a while ago to make a slightly different point. Grant is right, though, that the father-daughter aspect of your analogy is at least amusing and probably won't endear it to those you want to persuade. Of course, unlike the car in your analogy, health care coverage is not really a gift; it's a form of compensation. That difference may not be all-important in the larger controversy, but I think it does complicate the analogy. Let me tweak your analogy in a few small ways and see if those changes don't add up to an important difference. Let's say I want to buy my brother a car, partly in return for a large favor he's done for me. The government has issued a rule that says all car manufacturers must make disc brakes available to everyone who owns one of their cars. For whatever reason, I don't believe in disc brakes, only in drum brakes, and I refuse to buy a car with disc brakes even though it's for someone who actually prefers them. The government allows me to buy the car without disc brakes, but it requires the carmaker to offer disc brakes to my brother once he owns the car. The government also requires that the manufacturer replace the drum brakes with disc brakes at no cost to my brother. So, my brother ends up with a car that I paid for and that now has disc brakes. Is this exactly the same as my having bought him a car that had disc brakes to begin with? Or is it only trivially different? I'm not sure. Until we see the details of the new accommodation, no one can be sure how good either analogy is.

Sarah Kliffon the Post's Wonklong picks this problem out exactly:"The catch here is that theres a difference between revenue neutral and free. By one reports measure, it costs about $21.40 to add birth control, IUDs and other contraceptives to an insurance plan. Those costs may be offset by a reduction in pregnancies. But unless drug manufacturers decide to start handing out free contraceptives, the money to buy them will have to come from somewhere.Where will it come from, since neither employers nor employees will be paying for these contraceptives? That leaves the insurers, whose revenues come from the premiums that subscribers pay them. Its difficult to see how insurance companies would avoid using premiums to cover the costs of contraceptives. They could, perhaps, use premiums from non-religious employers. Those businesses wouldnt likely object on faith-based grounds, but they probably wouldnt be keen on footing the bill for people who arent on their payrolls."http://www.washingtonpost.com/blogs/ezra-klein/post/the-catch-in-obamas-... do Mary Ann Glendon & John Garvey (among others):"It is no answer to respond that the religious employers are not paying for this aspect of the insurance coverage. For one thing, it is unrealistic to suggest that insurance companies will not pass the costs of these additional services on to the purchasers. More importantly, abortion-drugs, sterilizations, and contraceptives are a necessary feature of the policy purchased by the religious institution or believing individual. They will only be made available to those who are insured under such policy, by virtue of the terms of the policy.It is morally obtuse for the administration to suggest (as it does) that this is a meaningful accommodation of religious liberty because the insurance company will be the one to inform the employee that she is entitled to the embryo-destroying five day after pill pursuant to the insurance contract purchased by the religious employer. It does not matter who explains the terms of the policy purchased by the religiously affiliated or observant employer. What matters is what services the policy covers."http://blog.archny.org/steppingout/?p=2229

OK, so now we not only have this fundamental right to have sex, but we have this fundamental right to have other people facilitate and subsidize our having sex.Here's a thought experiment for you:Since we're talking about cars -- during the debate on the individual mandate in ObamaCare, people repeatedly used mandatory auto insurance as an example (except that if you don't own a car, you're not mandated to have insurance).In addition to all those sex-rights, we also have a right to drink alcohol, including drinking alcohol in connection with having sex. (People have often found it easier to pick up someone at the bar for sex by the use of alcohol.)Since having other people facilitate and subsidize our having sex is our right (part of the right to privacy, you know), can government compel you, as part of your work-provided health insurance, to pay for the drinks that people have at the bar in order to pick up someone for sex? What if we're unsuccessful at the bar, but still want it, can we mandate that the services of a "sex therapist," i.e. prostitute, be covered under our health insurance?Or, since it actually saves money for them, can the government require auto insurance companies to pay to provide free taxi or limo service for people who have been drinking so that they don't drive while drunk?Or, even when not surfing for sex, can the government require auto insurance companies to provide free replacement tires for our cars, which will prevent blow-outs and accidents resulting therefrom?

Grant: Then I think we agree!Luke Hill: There is truth in what you say, but note that the Obama administration has been engaged in this sort of casuistry as well.Matt: If your analogy holds up, then the policy is as Grant takes it to be, and the contraceptive coverage is basically a separate rider that the employee can add to his or her policy at no charge. In this case I do think the policy would be immune to this particular objection -- though that doesn't change the fact that it's a bad law that should be opposed on the merits!

I'm grateful for many of the comments, on this and other posts, that offer different perspectives upon the original mandate and the "accommodation."Here is part of the letter sent to the bishops by the five who are most directly involved at the NCCB(the whole is posted on "Whispers in the Loggia" and was linked on another thread)."President Obama called our USCCB president, Cardinal-Designate Dolan, to tell him that significant changes would be made in the final federal rule in an effort to accommodate our concerns about the religious freedom of our institutions. He outlined these changes, and said the Administration would be in further dialogue with religious organizations to work out the questions that remain unanswered. He said White House officials were willing to meet with us to discuss the issue further. Later in the morning, senior White House staff came to our Conference headquarters to do so and to answer questions. Shortly after the announcement by President Obama, Conference staff held a conference call with staff from Catholic Relief Services, Catholic Charities, USA, Catholic Health Association, the University of Notre Dame and the Association of Catholic Colleges and Universities."A concern I have is whether the CHA and Catholic Charities USA were too precipitate in their seeming acceptance of the Administration's position. I would have thought more extended investigation and discernment were needed.

It may also be himself if it is a family policy and his wife and daughters use contraceptivesThat's right, as part of the family coverage of an employee health plan, it is not merely "women" who supposedly now have this right to free contraceptives, but it is also the employee's 11-year-old daughter who is entitled to go get the Pill and other powerful-hormone drugs for free (and places like Planned Parenthood will be happen to dispense them to your little girl (and collect the money from the insurer) all without having to bother you with the fact).

A concern I have is whether the CHA and Catholic Charities USA were too precipitate in their seeming acceptance of the Administrations position. I would have thought more extended investigation and discernment were needed.This is exactly what worries me. Until we have the text of the proposed law in front of us (as well as a clear account of how the practical concerns I raised in my earlier post will be addressed), we cannot say for sure that it passes muster in this particular respect.

I think a better though experiment would be to imagine that, based on some hypothetical report from "experts" that all insurance policies must include a subscription to a porn magazine because it has been shown to increase and sustain sexual interest in the middle aged and elderly.That might help non-Catholics of various faiths understand the outrage over forcing Catholic organizations to offer policies that include birth control, a move I think is wrong-headed, though I would construe a "catholic organization" as quite strictly limited to a parish, diocese, or organization that takes no tax money or services provided by tax money.However, I don't understand why this whole debacle seen as a legislative problem (whether turbochargers, "Debbie Does Dallas," or diaphragms) and not a pastoral one?The Church has said for 40 years that abortion, while legal, is a sin and that Catholics may not have one. It has said for even longer that contraception is a sin and that Catholics may not use it, even if it will now be offered free to everybody. It looks to me like the Church, unable to keep Catholic women in line on these issues, is focusing on federal laws rather than its own inability to make a compelling case for Catholic women to remain holy.The Amish manage to keep their communities faithful in the face of all sorts of laws that go against their teachings. And these are folks who rarely have more than an eighth grade education and a clergy who, like rabbis, support themselves in some trade or profession. So why aren't the bishops, with their ability to focus on this problem full-time and with their extensive PR machinery, able to help Catholics shun secularism as the Amish do?

"This is exactly what worries me. Until we have the text of the proposed law in front of us (as well as a clear account of how the practical concerns I raised in my earlier post will be addressed), we cannot say for sure that it passes muster in this particular respect."Perhaps. HOWEVER

HOWEVER (sorry hit the wrong key) --- we can discuss what has been relayed to date and discuss that. Which is what I believe has been done. If the policy differs from what was said it would be, then that changes things but does not make the analysis according to the claimed policy wrong. And more importantly, if one should just wait to see it, then isn't that true of the critics?

... we can discuss what has been relayed to date and discuss that.But the descriptions of the compromise that have been relayed so far are inconsistent with one another. Thus the purpose of this inquiry is to reveal what the policy would have to be like for it to count as one in which employers aren't forced to pay for the coverage of contraception. And there seems to be an agreement that this requires that the policy providing such coverage be distinct in some meaningful sense from the one paid for by the employer, which is something that the descriptions of the policy do not unambiguously guarantee.

"A concern I have is whether the CHA and Catholic Charities USA were too precipitate in their seeming acceptance of the Administrations position. I would have thought more extended investigation and discernment were needed."If you believe the NYTimes, Sr. Keehan was in the loop before the announcement:"We were getting killed, one administration official said Friday. The White House picked the deputy chief of staff Nancy-Ann DeParle to talk to Sister Keehan about ways the rule could be made palatable." from http://www.nytimes.com/2012/02/11/health/policy/obama-to-offer-accommoda... this is true, then that might explain why Sr. Keehan was ready to endorse the decision immediately - she knew what was coming. The bishops, on the other hand, pointedly say in their press conference that they were not consulted ahead of time. Interesting to speculate why.

"Until we have the text of the proposed law in front of us (as well as a clear account of how the practical concerns I raised in my earlier post will be addressed), we cannot say for sure that it passes muster in this particular respect."So how is it that conservatives are able to dismiss it out of hand? Jean: I think you need to read the stories again. They are not forcing Catholic organizations to offer policies that include birth control. Much less porn mags...

Equating contraception with pornography? Part of what makes this whole problem so strange is that even witnin the church, the idea that contraception is wrong is a contested minority opinion, and I'm not sure even one sincerely held by that minority. As so often seems to happen in Catholic theology, the argument's internal logic is more important to those arguing than the actual merits of the subject matter. This really doesn't seem to be about contraception at all but about power.

Because if you look at the funding mechanism it evacuates the complaint that the bishops led with -- namely that Catholic groups were being made to "pay for" services they deemed inimical to their religious beliefs.

"The catch here is that theres a difference between revenue neutral and free. By one reports measure, it costs about $21.40 to add birth control, IUDs and other contraceptives to an insurance plan. Those costs may be offset by a reduction in pregnancies. But unless drug manufacturers decide to start handing out free contraceptives, the money to buy them will have to come from somewhere."--Jeff LandryThe employer pays the Insurance company a fixed amount to cover all sorts of health issues, including pregnancies but not contraception. Once the insurance company has the money, it offers each employee a free insurance policy covering only contraception. The belief is that providing contraception will cost the insurance company less than it would have spent on the pregnancies that are avoided by the use of contraception. The insurance company makes more profit and the employer has not paid for contraception. That is what I understand the proposal to be. I have no personal knowledge of whether the savings in pregnancy cost balance the cost of contraceptives, but the HHS announcement refers to studies and examples. .

Grant:It is true that if you look at one of the administration's mutually conflicting accounts of the mechanism by which contraceptive service will be provided, then a certain complaint is rendered moot.It is also true that if you look at another of those accounts, the complaint seems well-founded.And as we don't yet have the text of the law in front of us, and political officials are known to ... well, spin things depending on their audience, it strike me as wise to withhold judgment, and to make it clear what the law would have to look like for it not to count as infringing on institutional conscience in this relevant respect.Or am I -- or the folks at First Things, perhaps, since this isn't actually my position -- similarly justified in proclaiming that the compromise is sure to be unsatisfactory, citing in my defense the fallible track record of those who claim that everything is okay, plus the fact that the only "official" description we have of the policy makes it look rather problematic?

Free church-sponsored porn for all!Honestly, that's not what I said, but clearly muddied the waters and failed to make any points that resonated here.My niece just had a preemie baby that's in the neonatal ICU. I will go work on a blanket for him and ask for your prayers for baby and parents. It's their first. That seems like a much more useful thing to do with my time than getting on here today.

Regarding the relative costs of contraception and pregnancy:"KATHLEEN SEBELIUS: Well, again, Ray, in this case, actuaries have looked at this benefit.The federal employees health plan, when contraception was added to federal employees' benefit, which is the largest employee group in the country, costed this as no cost, free, no cost, because adding contraception and having some employees take advantage of that coverage lowers the overall cost of the health plan.So we have that in place around the country. We have actuaries that have inserted that, and so we're not -- this isn't a shell game of passing the costs along. This is a real no-cost option that is, according to the National Business Council on Health, could reduce an insurance plan by about 15 percent. We're not counting on that.http://www.pbs.org/newshour/bb/politics/jan-june12/contraception_02-10.html

Bernard, You asked two questions and I think this one is the more germaine:2. Is it not the legal right of the state to determine which legal conditions of employment must obtain for all its citizens? More specifically, is it not the legal and moral right for the state to insist that, even if some legal condition happens to be objectively immoral, nonetheless good reasons can exist for not making the civil law outlaw every immoral practice?Lets start at the end and work back. In the question about contraceptive, the argument is not over outlawing an immoral practice but rather requiring it. Thats a fundamentally different position. And I believe that Catholic moral theology would say that the state has no right or authority under natural law to coerce such immoral behavior through law or otherwise. In fact, all people of good will should actively oppose such a law if the state tries to impose it. The beginning part of your question involves our constitution. The fundamental fact is that all laws are subordinate to the constitution. The first amendment specifically states in part 'Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof' so any law which prohibits the free exercise of a religious belief is illegal under our constitution. That would make any employment law or health care law or anything else passed by Congress illegal if it is determined to violate that provision, regardless of how well intentioned or popular it might be.

"Tu quoque arguments are fallacious, you know."True, John. So I'll say instead: you're wrong.But nice try. I also wonder what kind of a philosophical argument it is to question the veracity of your opponent as a way of winning an argument...?

John Schwenkler, regarding "mutually conflicting accounts," I think the reliable sourceis the notice posted on the White House website:That says hat "final rules" will be published today [Friday] in the Federal Register.In the meantime, it gives this summary:"Today, the Obama Administration will publish final rules in the Federal Register that:oExempts churches, other houses of worship, and similar organizations from covering contraception on the basis of their religious objections.oEstablishes a one-year transition period for religious organizations while this policy is being implemented.The President will also announce that his Administration will propose and finalize a new regulation during this transition year to address the religious objections of the non-exempted non-profit religious organizations. The new regulation will require insurance companies to cover contraception if the religious organization chooses not to. Under the policy:oReligious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.oReligious organizations will not be required to subsidize the cost of contraception.oContraception coverage will be offered to women by their employers insurance companies directly, with no role for religious employers who oppose contraception.oInsurance companies will be required to provide contraception coverage to these women free of charge.o The new policy does not affect existing state requirements concerning contraception coverage.Covering contraception is cost neutral since itsaves money by keeping women healthy and preventing spending on other health services. For example, there was no increase in premiums when contraception was added to the Federal Employees Health Benefit System and required of non-religious employers in Hawaii. One study found that covering contraception saved employees $97 per year, per employee.

This is a real no-cost option that is, according to the National Business Council on Health, could reduce an insurance plan by about 15 percent.If administration shills aren't misrepresenting this issue, then problem solved: No need for a mandate whatsoever. Just educate employers about a way to save 15% on their insurance costs, and nearly all of them will demand such policies on their own.

Since the Administration caused this furor in the first place by pulling the rug out from underneath its supporters after promising them - apparently personally by the President - that it would find a compromise acceptable to them, I don't see why it's out of bounds to hold some of the White House's statements with a healthy suspicion. If its acceptable to be skeptical of the Prolife Office, it seems equally acceptable to be of the White House, particularly given their recent (losing) track record on religious liberty issues. Add to that mix reports in Politico of the involvement og groups like "Catholics for Choice"' I fail to see why John & Robert Imbelli's positions of caution until the proposed rule is released is so objectionable.

I think many people - including Wonkblog on the Washington Post - know enough about the economics of health insurers to express some caution about how meaningful the accommodation is. Grant has raised a counter argument to those concerns re: the "separate policy" but that isn't a fact either.

If there is a compelling state interest in making sure that contraceptives are available to everyone at no out-of-pocket cost, then the state itself ought to subsidize contraceptives.If the money to pay for contraceptives isn't going to come from the policy holder or from the religious employer who pays for part of the policy holder's premiums, then it would have to come from some other employer's premiums. I am not a lawyer, but it seems very unlikely to me that the state can require insurers to pay for the contraceptives of one company's employees only with premiums from other companies.So where does the money come from? Why not the same government agency responsible for the mandate? As far as I know, there is no statute that would prevent the HHS from paying for contraceptives, and the argument for such a statute would be much weaker, legally and philosophically, then the argument against forcing religious employers to pay for contraceptives through their insurance premiums.But wouldn't this be a huge handout to the insurance companies, which would now have to pay for neither contraceptives nor the medical services that contraception preempts? Yes, it would. We would be treating the insurance companies like public utilities, which is what the Affordable Care Act already does. If this bothers you, there's an obvious alternative: a single-payer system, in which the government would be saving taxpayers--rather than insurance companies--money by providing coverage for contraception.

Bruce said: "That would make any employment law or health care law or anything else passed by Congress illegal if it is determined to violate that (free exercise) provision, regardless of how well intentioned or popular it might be."Therefore, anyone who claims that the free exercise of their religion (dogma? personal theology? divine revelation? peep stones?) can therefore discriminate by class, gender, race, sexual orientation, age, marital status, etc. under the umbrella of "free exercise?"Ask the LDS how they were able to practice polygamy under the "free exercise" clause. Ask Christian Scientists who want to withhold medical care from their minor children. Ask anyone who is not a member of the Native American Church is (s)he can use peyote in the "free exercise" of his/her religion. Ask anyone who is not a member of a religious group that expouses conscientious objection, but does so personally, if they can claim that status as part of their "free exercise" without one heck of a hassle that they will most likely lose. Ask parents who want to have a free hand in any kind corporal punishment of their children that happens to be in violation of various laws about the "free exercise" of their religious beliefs. Ask someone who takes the Hebrew Scriptures to heart and wants to own slaves about "free exercise."

" If this bothers you, theres an obvious alternative: a single-payer system, in which the government would be saving taxpayersrather than insurance companiesmoney by providing coverage for contraception."Well there's also the obvious alternative of ending the expensive and inefficient incentives of employer-provided insurance.

I'm not mocking them, Stuart. I'm pointing out that they are few in number. I have no problem with NFP. Jeff: Catholics for Choice came out against the revised mandate. They view it as an unnecessary capitulation to the Catholic bishops. And, as a Chicagoan, I support natural skepticism. Just as I took the administration at its word when it announced the original form of the mandate -- and criticized it again and again, without trying to persuade anyone that it was actually going to go a totally different way -- I really do think the administration intends to enact what this new mandate because Obama doesn't want this headache, and the new mandate achieves the policy goal (which he ran on) of reducing unintended pregnancies.

Regarding the notion that the Catholic institution ends up paying for the contraceptives anyway, because the insurance company will just pad its invoice to cover the contraceptive expense: Modern enterprises incur many expenses that aren't offset by directly charging clients for them. Everything from the cost of turning on the lights in the morning to keeping the data center powered up to the salaries of the back-office people to the marketing budget are considered overhead. In a sense, the company "eats" these expenses. But in another sense, it's a cost of doing business, and the trick is to bring in more than enough revenue, in total, to offset this overhead. Among these overhead expenses might be freebie products and services. Businesses give products and services away all the time, for a lot of reasons. Frequently it's done in an attempt to lure customers (e.g. the Pepsi Challenge, or free delivery from a pizza parlor), but there are other reasons: to satisfy a disgruntled customer; because its competitors do so and so it has to, too; because the government mandates it; and probably for other reasons, too. Those given-away items are expenses in the account's books. How do profit-making enterprise cover those expenses? I'd think the realistic answer is, "any way they can". Certainly, if it makes business sense, they may be able to pass those expenses along directly to individual customers whom they've identified as consumers of the free product or service, perhaps by padding the margin a bit on other items. But it's not always necessary to do this, and frequently not possible (as when marketing funds are used to give away free trials of a product), and inasmuch as it would now be illegal to charge it back to Catholic institutions, not always desirable.Insurance companies who provide health insurance services to Catholic institutions have all sorts of income streams coming in: premiums from Catholic institutions, premiums from non-Catholic institutions, income from investments, and probably other sources as well. At the end of the accounting period, the revenues and expenses from all these operations are all toted up, and hopefully the number at the bottom of the column isn't book-ended by parentheses. Yes, they could easily have a line item in their expenses entitled "contraceptive expenses". How is that expense offset? Not, I'd wager, through the simple expedient of piling a little extra margin onto the invoices of Catholic institutions.I just think that there is a ton of ambiguity in the accounts of a modern large enterprise. I suspect that, in real life, it will be virtually impossible to draw a straight line, or any line at all, from the premium paid by the Catholic institution for its employees' health insurance, to the contraceptive whose costs were covered by the insurance company.To my way of thinking, this all adds up to sufficiently remote cooperation in evil.